92-100782 MECHANICAL PERMIT 9�� ��d7S�
CITY OF BUILDING INSPECTION
FEDERALWAY BUILDING PERMIT 941-1555
PERMIT NO. 92-O7H4 M pWNER'S NAME SHERYL MARTIN JOB ADDRESS 300�. S ZHBTH �ZSO
CONTRACTOR �YES HEATING ADDRESS 2300 S 118TH SEATTLE CONT. PHONE 244-4328
CONT. REG. NO. H�YESHZOZQE OWNER'S PHONE 941-3606 OWNER'S ADDRESS 3001 S ZHHTH #ZSO FEDERAL WAY
TYPE JOB: NEW AESIDENCE ADDITION NEW INDUSTRIAL NEW COMMERCIAL COMMERCIAL ADD. INDUSTRIAL ADD. NEW PUBLIC PUBLIC ADD.
NEW MULTI-FAMILY (UNITS ) MULTI.ADD. SIGN GRADING OTHER
TAX ACGOUNT NO. O 4 2�.O 4-91 rJ S LEGAL DESCRIPTION
ISSUED BY JOANNE JOHNSON DATE OF ISSUE ' - DATE OF APPLICATION
BUILDING INFORMATION
ZONE OCCUPANCY TYPE OF CONSTRUCTION BLDG. SQ. FT.
SET BACKS: FRONT SIDE REAR STORIES HEIGHT LIMIT
PLUMBING NO. NO. MECHANICAL APPLIANCES AMT. AMT. BOND
WATER CLOSETS ELEC. HOT WATER HEATER GAS PIPING�-FT. ��QQ BOILER
RECEIVED
BATHTUBS LAUNDRY DRAINS COMPRESSOR TANK(S)
SHOWERS URINALS FORCED AIR FURNACE �QO AIR HANDLING UNIT NUMBER
LAVATORIES DRINKING FOUNTAINS GAS�iOT WATER HTR. 6_5n MISC.
RETURNED
SINKS MISC. CONVERSION BURNER BASIC FEE Z�QQ
DISHWASHERS TOTP.L FIXTURES UNIT HEATER TOTAL MECHANICAL-�r��- AMOUNT
VALUATION
GAS PIPING TEST MUST BE WITNESSED BY INSPECTOR. AFFIDAVIT WILL NOT SUFFICE.
PERMIT FEE
PLAN°CHECK FEE
LUMBING FEE INSPECTION RECORD
_.ECHANICAL FEE -����$- 3 H.S O
TOTAL BLDG. FEES Water Line �K Mechanical Inspection Notes:
PART P/C FEE
SEPA REVIEW GAS PIPING OK Date By
WATER SERVICE
WATER MAIN CHG.
S.B.C.C. FEE
OTHER FEES MECHANICAL PERMIT 38.50
AMOUNT DUE -��_��-- Account No. 010-000-322-10-004 Total Fee $ =�3=�� Receipt No.
ALL PERMITS EXPIRE 180 DAYS AFTER ISSUANCE IF NO WORK IS STARTED. RESIDENTIAL AND GRADING PERMITS EXPIRE ONE YEAR AFTER DATE OF ISSUANCE.
I CERTIFY THAT THE INFORMATION FURNISHED BY ME IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE AND THE APPLICABLE CITY OF FEDERAL WAY
REQUIREMENTS WILL BE ME :
OWNER OR AGENT �`^ DATE���� f -i`9�
��+� i m�t # �� ���
�1�/��
MAY 2 O 1992 CITY OF FEDERAL WAY �✓
����."�� BUILDING PERMIT APPLICATION
—Please Print—
BOX 1 TENANT NAME: ��
OWNER SITE LOCATION
OWNER'S ADDRESS -- CITY��_(�� PHONE Ci4/-Y'�1��_
DESCRIBE JOB
THE PROPERTY IS OWNED Y: SI GLE/MARRIED �/ PARTNERSHIP CORPORATION
BOX 2 CONTRACTOR'S NAME /�-��c� I��L�,� CONTRACTOR'S REG. #�A;�i= �� /a/1�%
Card MUS�be present�'d
CONTRACTOR'S ADDRESS ' � CITY �Sl�z2� PHONE � -�,"�2,F
EXPIRATION DATE
- — OR —
I HAVE READ CHAPTER 18.27.010 RELATING TO DEFINITIONS OF GENERAL CONTRACTORS AND SPECIALTY CONTRACTORS AND
CHAPTER 18.27.110 WHICH PROHIBITS ISSUING PERMITS WITHOUT PROOF OF REGISTRATION.
BOX 3 CONTACT PERSON �r►1 ..�c�j PHON�?�;� 24�.-�.71i'
� BOX 4 SEWER DISTRICT WATER DISTRICT
y�BOX 5 ESTIMATED PROJECT COST EXISTING BUILDING VALUATION
BOX 6 PROPERTY TAX ACCOUNT NUMB
LEGAL DESCRIPTION
(If necessary, please submit a separate page with the legal description.)
K.C. Plat Recording #
BOX 7 BUILDING SQUARE FOOTAGE: (Existing/Proposed) 1ST FLOOR / 2ND FLOOR / _
5c 3RD FLOOR / BASEMENT / DECK / GARAGE /
BOX 8 �SINGLE FAMILY ( NEW CONSTRUCTION
( ) MULTIFaMILY (N0. OF UNITS = ) � EXISTING STRUCTURE
O COMMERCIAL/INDUSTRIAL TOTAL AREA OF PROPERTY SQ FT
BOX 9 PLUMBING FIXTURES (including rough-ins) MECHANICAL APPLIANCES — BASIC FEE$
N0. WATERCLOSETS GAS PIPING, FEET �,9,��� � l�(� � $
BATHTUBS N0. FURNACE, ELEC. GAS_ $
SHOWERS GAS HOT WATER HEATER $
LAVATORIES CONVERSION BURNER $
SINKS BOILER, SIZE BTU $
DISHWASHERS AIR HANDLING UNITS $
ELECTRIC HOT WATER HEATER HEAT PUMPS, SIZE $
LAUNDRY WASHER OUTLET UNIT HEATERS $
URINALS AIR COOLING UNITS, SIZE $
DRINKING FOUNTAINS COMMERCIAL HOOD $
SUMPS, SPRINKLER VACUUM BREAKERS OTHER $
RAINS $
THER $
TOTAL FIXTURES $
TOTAL MECHANICAL FEE $
I CERTIFY U DER PENALTY OF PERJURY THAT THE INFORMATION FURNISHED BY ME IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE
AND FURTHER THAT I AM AUTHORIZED BY THE OWNER OF THE ABOVE PREMISES TO PERFORM THE WORK FOR WHICH PERMIT APPLICATION IS
MADE.I FURTHER AGREE TO SAVE HARMLESS THE CITY OF FEDERAL WAY AS TO ANY CLAIM(I NCLUDI NG COSTS,EXPENSES,AND ATTORNEYS'
FEES INCURRED IN INVESTIGATION AND DEFENSE OF SUCH CLAIM),WHICH MAY BE MADE BY ANY PERSON, INCLUDING THE UNDERSIGNED,
AND FILED AGAINST THE CITY OF FEDERAL WAY,BUT ONLY WHERE SUCH CLAIM ARISES OUT OF THE RELIANCE OF THE CITY, INCLUDING ITS
OFFICERS AND EMPLOYEES UPON THE ACCURACY OF THE INFORMATION SUPPLIED TO THE CITY AS A PART OF THIS APPLICATION.
�
OWNE AGENT: DATE: L � /9'�✓2
ANP-008 3/90